Chicagoland Christian Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CHICAGOLAND CHRISTIAN VILLAGE, INC.

Practice address

6685 E 117TH Ave
Crown Point, IN 46307-7808

Phone

(219) 662-0642

Fax

(219) 663-4260

NPI assigned

Jul 18, 2006

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Susan McGhee

Title

Controller

Phone

(217) 732-5175

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1174541809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6685 E 117TH AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077808",
            "telephone_number": "219-662-0642",
            "fax_number": "219-663-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6685 E 117TH AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077808",
            "telephone_number": "219-662-0642",
            "fax_number": "219-663-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGOLAND CHRISTIAN VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "MCGHEE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "217-732-5175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS PROVIDER NUM",
            "identifier": "000000272904",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Skilled Nursing Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.